What if anaphylaxis emergency treatment does not relieve facial swelling?

If facial swelling does not improve after anaphylaxis emergency treatment, call emergency services immediately and follow the prescribed emergency plan. Do not wait for the swelling to settle on its own. Tell the dispatcher that anaphylaxis treatment has already been given and that facial swelling is continuing.

An adrenaline auto-injector can slow a severe allergic reaction, but symptoms may continue, return, or involve more than one body system. Ongoing swelling of the lips, tongue, throat, or face can signal continuing airway risk. Other warning symptoms include a hoarse voice, trouble swallowing, wheezing, breathing difficulty, dizziness, faintness, confusion, vomiting, or widespread hives. A person can become seriously unwell even if the first symptoms seemed to ease.

The emergency team may need to monitor breathing and circulation and provide further treatment. Facial swelling has other possible causes, but swelling occurring with sudden breathing, throat, skin, stomach, or circulation symptoms should be treated as a possible anaphylactic emergency.

Stay with the person and keep them under observation. Help them use any additional adrenaline dose only if their prescribed plan or emergency dispatcher instructs this. Do not give food, drink, or oral medicine if swallowing is difficult, and do not ask them to stand or walk if they feel faint. Keep them in a comfortable position; someone struggling to breathe may need to sit upright, while someone feeling faint should lie down with their legs raised if this does not worsen breathing. If they become unresponsive and are not breathing normally, follow dispatcher instructions for resuscitation.

Keep the used auto-injector and any other medicines available for the clinicians. Note when symptoms began, what may have triggered them, and when treatment was given.

Continuing facial swelling after suspected anaphylaxis is itself a reason to seek emergency care now. Call emergency services urgently for any tongue or throat swelling, voice change, noisy breathing, shortness of breath, blue or grey lips, fainting, severe weakness, confusion, or rapidly worsening symptoms. Do not drive yourself to hospital if you are having breathing or circulation symptoms. Even after improvement, arrange medical observation because symptoms can recur and the treatment plan may need review.

Ask what may have triggered the reaction, when to use an adrenaline auto-injector, whether you need more than one device available, and how to recognise symptoms that require another dose or emergency call. Ask for a written action plan, advice about avoiding the suspected trigger, and a review of any medicines that could affect emergency treatment.